Saturday, March 28, 2009

Take on HealthCare



I've been thinking a lot about health-care and how it seems to be crippling our country.   I've heard a million answers and reasons (none of them any good or very convincing) why health-care is broke or why it's working right, why it needs just some tweaking or must be totally overhauled, why it must be nationalized or left alone etc.   

I’ll begin this entire thing with the following disclaimer..  Healthcare is one of those things I know very little about, it's the one item that as soon as a columnist takes it on is as soon as I zone out.   I’m not sure why I can’t get into it but it’s just not something I have the stomach for I guess. And I'm sure I’m going to get shot down by the left, right and middle for this blog item.  I’ve been thinking about this for the last few weeks and  it's apparent to me that we need to do something about it and I can't get the thought out of my mind that the way most people get their healthcare (through their employer) is a gigantic mistake for many reasons.

But my biggest issue is that we are misguided if we think that you can ask a company who by design should be based on generating revenue and maintaining margin should carry  the weight of health-care and continue to compete in a global market.

As a philosophical model , Health Care is not a burden employers should have to carry, it is crippling our employers and hurting our employees; health-care for individuals is not the responsibility of the employer in my eyes this goes against the principle of capitalism.  We have to let business be business not an entitlement center.   If you go back to the basics,  principle of business is to produce and sell widgets, generate revenue and maintain margin.   Business should be run to make money, do well for its shareholders, build product they are not in the health-care industry (unless your business happens to be called Blue Cross Blue Shield or Aetna or something).  In the 50's when there was a push to change health-care and take the cost and decision out of the hands of business but it got derailed by big business (GM and  Ford) when they decided that because they were doing so well they wanted to use health-care as part of their compensation package to attract better workers.   Ironically one of the reasons that Detroit is bankrupt (or should be allowed to go bankrupt) today is because of the immense costs of health-care for their present and past employees.   Recruitment of employees should be strictly in the form of cash, stocks, hours, vacation time etc. health-care and insurance should never get confused in this issue.

But past the inherent conflict of a capitalistic business model, this entitlement has become a forced expense since companies cannot properly recruit in these markets without offering health-care, in 2009 health care is a staple of any 'good' job.

There is a second  issue which is arguably more important, it is unfair for an employee to be forced into a plan that the owner's, CEO's or Board's of their companies decide to go with.  The health and well being of people is too important to have it be a line-item in a corporate budget which can be slashed or cut-up in back-rooms or board-rooms. The cost of health-care has forced companies to jump from insurance to insurance with obvious effects on long-term continuity which can obviously lead to inadequate care.  A typical employee in the US is forced to scramble to find new doctors and hospitals within the health-care’s network every few years as their companies make decisions to switch health-care providers.   Just like people will make the argument that congresspeople should not be making these decisions for individuals , the should also not be made by suits with red-ink pens as they try to compete worldwide against other companies who do not have these burdens..

Health-care should not be a business issue or government issue , it should be an individual issue, one decided by people and not something funded (directly) by companies.  I think Health Care is something that should be responsibility mainly of the individual with a safety net of the state but the concept that a business pays for the cost of insuring a nation is ludicrous.

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